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College of Physicians and Surgeons launches review of sexual abuse policy

The College of Physicians and Surgeons will review its policies on sexual abuse following a Star investigation into doctors who continue to practise after being found guilty of misconduct for sexually abusing patients.

Since September, the Star has reported on five physicians practising with gender restrictions. Each is facing a disciplinary hearing or has been found guilty of sexual abuse related to his practice.

“We’ve seen a lot of news in the media, and society being very concerned about sexual abuse, and we really felt it was time to look at our processes,” said incoming college president Dr. Carol Leet.

The college review will look into:

Whether there should be harsher penalties for sexual abuse findings that do not trigger a mandatory licence revocation.

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Whether gender-based restrictions, such as being able to treat only male patients or see female patients with a chaperone, are appropriate.

Whether the college should automatically report sexual abuse complaints to the police.

He pleaded not guilty to sexual assault in those cases and the other four charges were withdrawn.

Peirovy was “reckless” in not getting specific consent to placing his stethoscope on or around two patients’ nipple area, and in one case “incidental touching” of a patient’s nipples with his fingertips, according to a joint statement of facts read at his trial. He was given 18 months probation and ordered to attend counselling, complete 100 hours of community service and make a $600 charitable donation.

“I have zero tolerance for any criminal sexual behaviour and will — after a thorough review by experts and victims’ advocates — make any and all necessary changes to ensure Ontarians are protected,” he said.

This will be examined as part of a review Hoskins ordered this fall of the Regulated Health Professions Act (RHPA), following the Star’s investigation of sexual abuse by doctors. The decades-old legislation covers all 23 provincial health regulatory bodies.

Currently there is no automatic licence revocation for criminal offences by doctors, only for certain sexual acts with patients. Those acts include sexual intercourse, oral-to-genital contact, genital-to-genital contact, genital-to-anal contact and masturbation.

When it comes to sexual abuse outside those defined acts, such as inappropriately touching a patient’s breasts, the college has discretion to revoke a licence but is not required to do so.

“We certainly don’t hesitate to go for revocation if it’s warranted,” said Leet, adding that college counsel can ask for this but ultimately it’s the disciplinary panel’s decision.

McPhedran questions how the college uses its powers, noting it requires physicians applying for membership to undergo a criminal record check.

“Why would there be a higher standard for entering practice compared to the standard when somebody is already practising?” she asks.

Before the college can determine a penalty for Peirovy, it must go forward with a disciplinary hearing in January to prove the actions constitute professional misconduct.

The disciplinary panel will hear allegations of sexual abuse against Peirovy from the same six patients who brought sexual assault charges against him. The allegations include inappropriately touching the breasts and/or nipples of all six patients and placing a stethoscope on or around the nipples of three patients, according to the college’s notice of hearing document. In one case, he is also alleged to have asked the patient out on a date.

In 2011, the college put a gender-based restriction on his licence: Peirovy must have a nurse with him at all times while treating female patients.

Peirovy is one of 20 doctors in Ontario with a gender-based restriction on his licence. Regardless of his criminal conviction, college spokesperson Kathryn Clarke said this restriction was put on Peirovy as the college tries to impose the “least restrictive” conditions that still “provide public protection” until the disciplinary panel hears the allegations.

McPhedran says the college has the power to take stronger action immediately, especially since a decision has been made in court that suggests public safety may be at risk.

“The college clearly has the discretion to suspend his practice,” said McPhedran.

She noted the college took more than a year to conduct its own hearing, falling “short of the legislative standard for timely procedures in such cases per the RHPA and its Procedural Code.”

McPhedran said responsibility to keep the public safe also lies with the government. The RHPA delegates responsibility to govern doctors to the college, but a clause in the legislation says the minister may make regulations “governing the issue, renewal, suspension, revocation and expiration of certificates of authorization.”

McPhedran said this discretion can be used in cases where the college’s actions seem “too lax” to protect the public.

“This ministerial discretion may also need to be exercised to address when CPSO decision-makers opt to let doctors … continue to practise after admitting guilt for assaulting female patients.”

McPhedran was on the provincial task force that recommended the college include findings of guilt related to disciplinary decisions and court decisions in 1991 and again 10 years later.

Medical secrecy has been investigated by the Star since 1997. The province pushed for more transparency after a 2007 Star series revealed how little information is available to the public, including negligence by doctors and infection rates at hospitals. In 2009, health professionals were required to report findings of guilt to their respective colleges by the Health Systems Improvement Act. But the law did not require this information to be provided to the public, said Clarke.

“The decision to add information to the college’s public register about criminal findings against doctors and bail conditions that affect their practice is the completion of another step in our plan to increase transparency,” she said.

The college began to look at improving public access to information about physicians in 2012, such as including findings of professional misconduct in the public register.

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